In this project, the ADHERE study, we will expand an NIAAA-funded observational cohort of alcohol abusing HIV-infected patients from 120 to 240 and randomized half of the participants to standard care and half to intervention to enhance medication adherence. We have developed a multi-faceted, pragmatic intervention which incorporates 4 components: addressing alcohol problems based on a patients readiness for behavioral change, distributing a practical aid to facilitate pill taking, enhancing a patient's perception of medication efficacy, and providing individualized assistance with pill taking tailored to a patient's specific circumstances. The ADHERE study will enable us to develop a generalize intervention to enhance antiretroviral medication adherence in-patients with a history of alcohol abuse and test its efficacy in terms of important clinical outcomes.